Courage and tragedy in clinical medicine.

The relationship between medical clinicians and patients is described as potentially tragic in nature and a context in which courage can be a relevant virtue. Danger, risk, uncertainty, and choice are presented as features of clinical relationships that also function as necessary conditions for courage. The clinician is seen as a 'sustaining presence' who has duties of 'encouragement' with respect to patients. The patient is seen to have a duty to learn the condition of human existence which can be discovered in clinical relations and to develop the virtues necessary to a fitting negotiation of human life. Case examples of courage on the parts of the principal participants in the clinical encounter are provided. In addition, several goods for clinicians and patients as objects of courage are identified.